Names and pronunciation
(eye-byoo′tih-lide) Corvert
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Drug reference
(eye-byoo′tih-lide) Corvert
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Func. class.: Antidysrhythmic (class III)
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Chem. class.: Methane sulfonamide
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ACTION: Prolongs duration of action potential and effective refractory period
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USES: For rapid conversion of atrial fibrillation/flutter, including within 1 wk of coronary artery bypass or valve surgery
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CONTRAINDICATIONS: Hyper- sensitivity breastfeeding, children <18 yr Precautions: Pregnancy, geriatric patients, sinus node dysfunction, 2nd- or 3rd-degree AV block, electrolyte imbalances, bradycardia, renal/hepatic disease, HF
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Black Box Warning: Life threatening dysrrthmias: QT prolongation, torsades de pointes, ventricular arrhythmias, ven- tricular tachycardia, cardiac dysrhyth- mias, atrial fibrillation Black Box Warning: ECG continuously for ≥4 hr to determine product effective- ness; measure PR, QRS, QT intervals, check for PVCs, other dysrhythmias; discontinue if atrial fibrillation/flutter ceases; continue un- til QT interval corrected for heart rate (QTc) returned to baseline; if atrial fibrillation lasts more than 2 days, anticoagulation must be adequate >2 wk before use • I&O ratio; electrolytes: potassium, so- dium, chlorine • Hepatic studies: AST, ALT, bilirubin, alk phos • Dehydration or hypovolemia • Rebound hypertension after 1-2 hr • Cardiac rate, respiration: rate, rhythm, character, chest pain • Pregnancy/breastfeeding: use only if benefits outweigh fetal risk; avoid breast- feeding, excretion unknown
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SIDE EFFECTS CNS: Headache, syncope, stroke CV: Hypotension, bradycardia, sinus arrest, HF, dysrhythmias, torsades de pointes, hypertension, extrasystoles, ven tricular tachycardia, bundle branch block, AV block, palpitations, supraventricular extrasystoles, syncope, prolonged QT interval GI: Nausea
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INTERACTIONS Increase: prodysrhythmia—phenothiazines, tricyclics, tetracyclics, antidepressants, H1-receptor antagonists, antihistamines Increase: masking of cardiotoxicity— digoxin • Do not use within 5 hr of ibutilide: class Ia antidysrhythmics (disopyramide, quiNI Dine, procainamide), class III agents (amio darone, sotalol); QT prolongation may occur
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DOSAGE AND ROUTES Atrial fibrillation/flutter • Adult ≥60 kg: IV INFUSION 1 vial (1 mg) given over 10 min, may repeat same dose after 10 min • Adult <60 kg: IV INFUSION 0.01 mg/ kg given over 10 min, may repeat same dose after 10 min
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Available forms: Inj 0.1 mg/mL in 10-mL vials
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Administer: • Ice compress after stopping infusion for extravasation; tubing should be re moved and attempt to aspirate product; elevate affected areas IV route • Do not use if discolored or particulate is present • Undiluted or diluted in 50 mL 0.9% NaCl, or D5W (0.017 mg/mL); give over 10 min • Solution is stable for 48 hr refrigerated or 24 hr at room temperature • Do not admix with other sol, products • Reduce dosage slowly with ECG moni- toring • Stop infusion as soon as arrhythmia is controlled
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Assess: I
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Evaluate: • Therapeutic response: decrease in atrial fibrillation/flutter
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To report side effects immediately, pain at injection site • About reason for medication
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PHARMACOKINETICS Half-life 6 hr, metabolized by liver, excreted by kidneys
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• Adult ≥60 kg: IV INFUSION 1 vial (1 mg) given over 10 min, may repeat same dose after 10 min
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• Adult <60 kg: IV INFUSION 0.01 mg/ kg given over 10 min, may repeat same dose after 10 min
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